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CITY OF OSHKOSH N ° - 46070
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG Te SIGN ❑ ZONING FLOOD PLAIN HEIGHT
3 / I JJ ' ' / b IMIF
/-- `"L PLAN NO.
OWNER / . <
DESIGNER f / f____el
USE/NATURE OF WORK
SSE ° ,
BUILDING CONTRACTOR
Size Sq. Ft. # Rooms # Stories Height
Foundation Class of Const. Occupancy Permit
HEATING CONTRACTOR
Heat ❑ A/C ❑ Vent ❑ Fuel /System Heat Loss BTU'S
ELECTRIC CONTRACTOR
Electric Serv. New ❑ Change ❑ Temp ❑ Type Volts Amps
Fixtures Switches Receptacles Circuits
PLUMBING CONTRACTOR _._-1 /4 �lL-a
BT — WH . — Disp — WSoft —pp CBasin /
— Lav — Sh — DW — DF l San. Sewer � f � C
— WC FDr — Sp — Ur ( Storm Sewer c i f C
— Sink — LTub — Eject — SS ____L Water
Other
FEES: Valuation $ /�Q O , d Per n e) I
Fee Paid $ Park Dedication $
ISSUED BY -./.../..- Date ? - / P 'Po
Final/O.P.
In the performance •
411 this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE �'' ` //lc--s-z---z--"--ek-- C AGENT /OWNER / DATE
DRESS 9sy 1 /C 4) c (9i o,..)i'‘ 75
TELEPHONE #
Plumbing Permit Work Card
Job Address 3194 BELLFIELD DR Permit Number -SWIM– e 7, Create Date 07/18/95
Owner Contractor HANNA EXCAVATING
^ gtegory 401 - Residential- Exterior (laterals) Plan Value $1,500.00
.thtub Shower Ejector /Grind Dip Well F Prep Sink Grease Trap
Whirlpool Floor Drain Water Softner Drink Ftn Sery Sink Receptor
Lavatory Lndry Tray Local Waste Wait. St. Shamp Sink Other
Toilet Lndry Stndp Clothes Wshr Ice Chest FIr/Wst Sink
Res. Sink Disposal Bidet Exam Sink Catch Basin
Bar Sink Dishwasher Beer Tap /Soda Sculry Sink Wash Ftn
Water Heater Sump Pump Dent. Oper. Hand Sink Urinal
Use /Nature —
of Work
NSF OUTSIDE PLUMBING
Size Material Type # Conn.Type
Sanitary Sewer
4 Plastic Lateral 1 New
Storm Sewer
4 Plastic Lateral 1 New
..Ater Service
1 Copper Lateral 1 New
Date Type Inspector Approved
S C 7- -1ST